From the Research
The treatment of mandible osteomyelitis should prioritize surgical intervention, with antibiotic therapy tailored based on culture results and the extent of infection, as evidenced by the most recent study 1. The management approach should combine surgical debridement to remove all infected and necrotic bone tissue, with a focus on resection as the most effective surgical option, as suggested by the systematic review 1.
- Key considerations in the treatment of mandible osteomyelitis include:
- Surgical intervention: resection, saucerization, decortication, or segmental resection in advanced cases
- Antibiotic therapy: empiric therapy with amoxicillin-clavulanate or clindamycin, with definitive therapy guided by culture results
- Adjunctive treatments: hyperbaric oxygen therapy, pain management, nutritional support, and maintenance of oral hygiene
- Regular follow-up with clinical and radiographic assessment to monitor treatment response The optimal duration of antibiotic therapy remains uncertain, but evidence suggests that 4-6 weeks of treatment is sufficient, with no added benefit from longer regimens 2.
- The choice of antibiotic should be guided by culture results and susceptibility testing, with consideration of oral antibiotics as a viable alternative to parenteral therapy 2. The goal of treatment should be to achieve complete resolution of the infection, with a focus on minimizing morbidity, mortality, and improving quality of life, as supported by the most recent and highest quality study 1.